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<div class="well">
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        <form name="myForm" id="myForm" action="modules/newUser.php" method="post" class="form-horizontal" role="form" target="response">
			<legend>Seleccione una Institucion Medica</legend>
		<div class="form-group">	
			<div class="col-lg-12">
				<label for="txtNombre" class="control-label">Nombre</label>
				<input type="text" class="form-control input-sm" name="txtNombre" id="txtNombre" placeholder="Escuela de Medicina">				
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		<hr>
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				<label for="txtDireccion" class="control-label">Dirección:</label>
				<input type="text" class="form-control input-sm" name="txtDireccion" id="txtDireccion" placeholder="Av Lopez Mateos">				
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				<label for="txtTel" class="control-label">Telefono:</label>
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